Cholesterol efflux capacity, HDL cholesterol, and risk of coronary heart disease: A nested case-control study in men

Leah E. Cahill, Frank M. Sacks, Eric B. Rimm, Majken K. Jensen

Research output: Contribution to journalArticlepeer-review

27 Citations (Scopus)

Abstract

The capacity of HDLs to accept cholesterol effluxing from macrophages has been proposed as a new biomarker of HDLs' anti-atherogenic function. Whether cholesterol efflux capacity (CEC) is independent of HDL cholesterol (HDL-C) as a biomarker for coronary heart disease (CHD) risk in a generally healthy primary-prevention population remains unanswered. Therefore, in this nested case-control study, we simultaneously assessed CEC (using J774 cells) and plasma HDL-C levels as predictors of CHD in healthy middle-aged and older men not receiving treatment affecting blood lipid concentrations. We used risk-set sampling of participants free of disease at baseline from the Health Professionals Follow-Up Study, and matched cases (n = 701) to controls 1:1 for age, smoking, and blood sampling date. We applied conditional logistic regression models to calculate the multivariable relative risk and 95% CIs of CHD over 16 years of follow-up. CEC and HDL-C were correlated (r = 0.50, P < 0.0001). The risk (95% CI) of CHD per one SD higher CEC was 0.82 (0.71-0.96), but completely attenuated to 1.08 (0.85-1.37) with HDL-C in the model. The association per one SD between HDL-C and CHD (0.66; 0.58-0.76) was essentially unchanged (0.68; 0.53- 0.88) after adjustment for CEC. These findings indicate that CEC's ability to predict CHD may not be independent of HDL-C in a cohort of generally healthy men.-Cahill, L. E., F. M. Sacks, E. B. Rimm, and M. K. Jensen. Cholesterol efflux capacity, HDL cholesterol, and risk of coronary heart disease: a nested case-control study in men. J. Lipid Res. 2019. 60: 1457-1464.

Original languageEnglish
Pages (from-to)1457-1464
Number of pages8
JournalJournal of Lipid Research
Volume60
Issue number8
DOIs
Publication statusPublished - 2019
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by Foundation for the National Institutes of Health Grants R01 HL35464 and UM1 CA167552. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Manuscript received 6 March 2019 and in revised form 9 May 2019. Published, JLR Papers in Press, May 29, 2019 DOI https://doi.org/10.1194/jlr.P093823

Funding Information:
This work was supported by Foundation for the National Institutes of Health Grants R01 HL35464 and UM1 CA167552. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
Copyright © 2019 Cahill et al.

ASJC Scopus Subject Areas

  • Biochemistry
  • Endocrinology
  • Cell Biology

PubMed: MeSH publication types

  • Clinical Trial
  • Journal Article
  • Multicenter Study
  • Research Support, N.I.H., Extramural

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